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Alvarez-Bruned L, Garcia-Continente X, Gotsens M, Pérez A, Pérez G. Trends in Inequalities in the Use of Condom by Urban Teenagers in Spain. J Urban Health 2015; 92:1065-80. [PMID: 26373424 PMCID: PMC4675735 DOI: 10.1007/s11524-015-9985-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Social and economic inequalities in condom use by adolescents have been reported previously. Also, condom use has declined during the last decade. The aim of the study was to describe trends in the use of condoms in our setting, and how these trends may differ between socioeconomic groups in boys, and separately in girls, aged 17-19 years attending school in Barcelona between 2004 and 2012. We analyzed data from three annual surveys on risk factors in secondary students, which included a representative sample of the city's population; individuals who had previously had sexual intercourse (n = 1570) were included in the study. We calculated adjusted prevalence ratios (aPR) and their confidence intervals (95% CI) using robust Poisson regression models. The prevalence of condom use among boys was 87.0% in 2004 and 76.2% in 2012, and 76.7 and 64.7% among girls, respectively. This decrease was greater in adolescents with a low socioeconomic level, both in boys (aPR = 0.80) and girls (aPR = 0.84). The observed increase of socioeconomic inequalities in condom use in adolescents highlights a possible deterioration in good sexual practices and policies during the studied period.
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Affiliation(s)
- Laia Alvarez-Bruned
- Faculty of Health and Life Sciences, University Pompeu Fabra, Barcelona, Spain
| | - Xavier Garcia-Continente
- Health Information System Service, Barcelona Agency of Public Health, Plaça Lesseps, 1, 08023, Barcelona, Spain.,Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau) (Institute of Biomedical Research), Barcelona, Spain
| | - Mercè Gotsens
- Health Information System Service, Barcelona Agency of Public Health, Plaça Lesseps, 1, 08023, Barcelona, Spain.,CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Anna Pérez
- Health Information System Service, Barcelona Agency of Public Health, Plaça Lesseps, 1, 08023, Barcelona, Spain.,CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau) (Institute of Biomedical Research), Barcelona, Spain
| | - Gloria Pérez
- Faculty of Health and Life Sciences, University Pompeu Fabra, Barcelona, Spain. .,Health Information System Service, Barcelona Agency of Public Health, Plaça Lesseps, 1, 08023, Barcelona, Spain. .,CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain. .,Institut d'Investigació Biomèdica de Sant Pau (IIB Sant Pau) (Institute of Biomedical Research), Barcelona, Spain.
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Ritchwood TD, Ford H, DeCoster J, Sutton M, Lochman JE. Risky Sexual Behavior and Substance Use among Adolescents: A Meta-analysis. CHILDREN AND YOUTH SERVICES REVIEW 2015; 52:74-88. [PMID: 25825550 PMCID: PMC4375751 DOI: 10.1016/j.childyouth.2015.03.005] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This study presents the results of a meta-analysis of the association between substance use and risky sexual behavior among adolescents. 87 studies fit the inclusion criteria, containing a total of 104 independent effect sizes that incorporated more than 120,000 participants. The overall effect size for the relationship between substance use and risky sexual behavior was in the small to moderate range (r = .22, CI = .18, .26). Further analyses indicated that the effect sizes did not substantially vary across the type of substance use, but did substantially vary across the type of risky sexual behavior being assessed. Specifically, mean effect sizes were smallest for studies examining unprotected sex (r = .15, CI = .10, .20), followed by studies examining number of sexual partners (r = .25, CI = .21, .30), those examining composite measures of risky sexual behavior (r = .38, CI = .27, .48), and those examining sex with an intravenous drug user (r = .53, CI = .45, .60). Furthermore, our results revealed that the relationship between drug use and risky sexual behavior is moderated by several variables, including sex, ethnicity, sexuality, age, sample type, and level of measurement. Implications and future directions are discussed.
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Affiliation(s)
| | - Haley Ford
- University of Texas Health Sciences Center at San Antonio
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Donadiki EM, Jimenez-Garcıa R, Velonakis EG, Hernandez-Barrera V, Sourtzi P, Lopez de Andres A, Jimenez-Trujillo I, Pino CG, Carrasco-Garrido P. Factors related to contraceptive methods among female higher education students in Greece. J Pediatr Adolesc Gynecol 2013; 26:334-9. [PMID: 24075084 DOI: 10.1016/j.jpag.2013.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/14/2013] [Accepted: 06/17/2013] [Indexed: 10/26/2022]
Abstract
STUDY OBJECTIVE We aimed to determine the prevalence of contraceptive methods and identify factors associated with the use of contraception by Greek female higher education students. DESIGN Cross-sectional epidemiologic survey on the factors determining the use of contraception among higher educational students. SUBJECT 3,624 female students between 18 and 26 years of age. MAIN OUTCOME MEASURES We used primary individualized data drawn from a survey carried among female college students in Greece. The dependent dichotomous variables were the responses "YES" or "NO" to the question: "During the last 12 months, what contraceptive method have you generally used in your sexual intercourses?" The methods were male condoms, oral contraceptive use (OCs) and emergency contraception (EC). The independent variables which were analysed in this survey were socio-demographic characteristics, variables related to lifestyle and variables associated with sexual habits. RESULTS Condom was the most widely used (53.87%). The variables associated independently and significantly with a greater likelihood of the use of condoms were condom use at first sexual intercourse, occupational status and higher educational level of parents. As for OCs, those who had relationship, had more than 2 sexual lifetime partners and had ever visited gynecologist (OR 6.40; 95%CI 2.80-9.40) was more likely to use. For the use of EC, those who were older, had relationship, were smokers and had more than 2 sexual lifetime partners (OR 2.15; 95%CI 1.75-2.64), was more likely to use this method. CONCLUSIONS Condom is the most used contraceptive method among female higher educational students in Greece, followed by EC. The variable most strongly associated with use of the OCs was a gynecologist visit. The factors associated with use of EC were having more than 2 sexual partners, smoking, and having a stable sexual partner.
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Affiliation(s)
- Elisavet M Donadiki
- Department of Public Health, University of Athens, Faculty of Nursing, Athens, Greece
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Shalev O, Baum N, Itzhaki H. "There's a man in my bed": the first experience of sex among Modern-Orthodox newlyweds in Israel. JOURNAL OF SEX & MARITAL THERAPY 2013; 39:40-55. [PMID: 23152968 DOI: 10.1080/0092623x.2012.675021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The first experience of sex is a significant life event for men and women. Studies investigating first-time sex focus largely on relationships at a young age and among teenagers, whereas studies of that experience in the context of marriage are extremely sparse and focus mainly on clinical population of unconsummated marriage. The authors explore the individual and mutual emotional effect of first-time intercourse among Modern-Orthodox newlywed couples in Israel. In-depth interviews with 36 men and women during their first year of marriage revealed unique challenges and difficulties related to sexuality in general and to first sex experience in particular. The findings indicate that first sexual intercourse is experienced by men and women as associated with emotional and behavioral difficulties, which appear to be rooted in the traditional nature of the religious Modern-Orthodox society in Israel. The authors explore reasoning and justifications for these challenges and detail different coping strategies-of the individual and of the couple. The findings might be relevant for other traditional societies in which couples experience sex only after marriage. The findings might also support professionals and sex therapists in addressing newlywed couples' needs in similar traditional populations.
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Affiliation(s)
- Ofra Shalev
- Zefat Academic College, Social Work, Zefat, Israel.
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Gil-Lacruz AI, Gil-Lacruz M, Bernal-Cuenca E. Socio-Economic Determinants of Abortion Rates. SEXUALITY RESEARCH AND SOCIAL POLICY 2012; 9:143-152. [DOI: 10.1007/s13178-011-0056-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
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Ferreira MMDSRDS, Torgal MCLDFPR. [Life styles in adolescence: sexual behavior of Portuguese adolescents]. Rev Esc Enferm USP 2011; 45:589-95. [PMID: 21710062 DOI: 10.1590/s0080-62342011000300006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 09/06/2010] [Indexed: 11/22/2022] Open
Abstract
Recent studies have shown that adolescents have initiated their sex lives earlier and earlier, without, however, receiving consistent sex education. The objectives of this study were to analyze the sexual behavior of adolescent high school students and identify the habits of sexual health in sexually active adolescent high school students. An exploratory study was conducted with 680 adolescents, whose age ranged between 15 and 19 years. Results showed that most participants had not initiated their sex life; boys are those who most report having had sexual relations; not all the interviewed adolescents used condoms during sex; most adolescents do not practice sexual health surveillance. It is important for sexually active adolescents to receive health care and counseling. Health institutions and their workers must be proactive in trying to approach adolescents.
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Carrasco-Garrido P, López de Andrés A, Hernández Barrera V, Jiménez-Trujillo I, Santos-Sancho J, Jiménez-García R. Predictors of contraceptive methods among adolescents and young women residing in Spain. J Sex Med 2011; 8:2431-8. [PMID: 21676190 DOI: 10.1111/j.1743-6109.2011.02346.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Preventing unwanted pregnancy is considered one of the main preventive measures of a developed health system. AIMS The aim of the study were to determine the prevalence of contraceptive methods and identify factors associated with the use of contraception by adolescents and young women residents in Spain. METHODS Descriptive cross-sectional epidemiologic study on the factors determining use of a contraceptive method among sexually active adolescents and young women aged 16-29 years, living in Spain. As the dependent variable, we took the answer to the questions "During the last 12 months, what contraceptive method have you generally used in your sexual relations?" Independent variables were socio-demographic factors, sexual habits, and variables associated with perception of sexual health. Using logistic multivariate regression models, we have estimated the independent effect of each of these variables on the contraceptive methods use. MAIN OUTCOME MEASURES We used secondary individualized data drawn from the first National Sexual Health Survey conducted in Spain. RESULTS The male condom seems to be the most widely used (56.7%). The likelihood of using a condom is greater to those who have more than two sexual partners (adjusted odds ratio [AOR]=3.11; 95% confidence interval [CI], 1.72-5.60). Predictors of use of oral contraceptives as the only method are age and having a positive view of one's sexual health (AOR=2.65; 95% CI, 1.28-5.45). Young women with two or more sexual partners were three times likelier to use the double method (AOR=3.83; 95% CI, 1.52-9.65). CONCLUSIONS The number of sexual partners, information on and importance of sexuality in one's life predicted the use of the condom as the only method. The factors associated with use of oral contraceptives were having a stable sexual partner and good perception of sexual health. The variable most strongly associated with use of the double method was number of sexual partners.
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Affiliation(s)
- Pilar Carrasco-Garrido
- Department of Preventive Medicine and Public Health, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
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Patseadou M, Galli-Tsinopoulou A, Goulis DG, Arvanitidou M. Factors associated with the onset of sexual activity among Greek high school students. EUR J CONTRACEP REPR 2011; 15:357-66. [PMID: 20863258 DOI: 10.3109/13625187.2010.514080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To record variables of the sexual behaviour of high school students in Northern Greece and to investigate factors associated with the onset of sexual activity. METHODS A questionnaire (Centers of Disease Control /Prevention) adapted to national characteristics, was distributed to students from a representative sample of 11 high schools (7 public, 2 private, 2 vocational). A total of 523 students (1st, 2nd, 3rd grade) completed the questionnaire. Frequencies of certain sexual behaviours were estimated and multivariable logistic regression models were used to evaluate correlates of the onset of sexual activity. RESULTS Onset of sexual activity was reported by 48% of adolescents, half of whom stated this had occurred by the age of 15. At last sexual intercourse 76% had used a condom and 21% no contraception at all. Initiation of sexual activity was influenced by gender, age, type of school and smoking. Boys, students attending vocational high schools and smokers were significantly more likely to have been sexually active. CONCLUSIONS Sexually-related behaviours among Greek high school students are quite frequent; they should be regularly registered. Sexual education programmes specifically designed for youths must be implemented.
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Affiliation(s)
- Magdalini Patseadou
- 4th Department of Paediatrics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ruiz-Muñoz D, Pérez G, Garcia-Subirats I, Díez E. Social and Economic Inequalities in the Use of Contraception Among Women in Spain. J Womens Health (Larchmt) 2011; 20:403-11. [DOI: 10.1089/jwh.2010.2004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Dolores Ruiz-Muñoz
- Health Information Systems Service, Barcelona Public Health Agency, Barcelona, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Spain
- Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Gloria Pérez
- Health Information Systems Service, Barcelona Public Health Agency, Barcelona, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Spain
- Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - Irene Garcia-Subirats
- Health Information Systems Service, Barcelona Public Health Agency, Barcelona, Spain
- Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Elia Díez
- CIBER in Epidemiology and Public Health (CIBERESP), Spain
- Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Preventive Interventions and Programs Service, Barcelona Public Health Agency, Barcelona, Spain
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Yilmaz HB, Kavlak O, Atan SU. Sexual activity, knowledge and contraceptive usage by gender among university students in Turkey. EUR J CONTRACEP REPR 2010; 15:433-40. [PMID: 20874085 DOI: 10.3109/13625187.2010.515045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess sexual activity and contraceptive knowledge and practice by gender among university students. METHODS Descriptive and cross-sectional study conducted at Ege University, Turkey, with 1000 volunteering students. Data collection was stopped when 500 students of each gender had participated. RESULTS Of the surveyed students, 50.3% (27.4% female, 73.2% male) reported having had sexual intercourse; the mean age at first sexual intercourse was 18.4 years for girls and 16.9 years for boys. We found that 44.5% of female and 30.6% of male students failed to use contraception at their first coitus, whereas 2.2% of female and 13.7% of male students failed to do so at their most recent intercourse. The rate of condom usage for students' first sexual encounter was 50.1% (35.8% female, 55.5% male) and was 67.8% (70.1% female, 66.9% male) at their most recent intercourse. Abortion was mentioned by 43.9% of female and 39.2% of male students as a method of preventing pregnancy after unprotected coitus. CONCLUSION Male Turkish students had started sexual relations at a younger age but had less often unprotected first sex than female students.
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Affiliation(s)
- Hatice Bal Yilmaz
- Department of Paediatric Nursing, Ege University School of Nursing, Bornova, Izmir, Turkey.
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Brown S, Guthrie K. Why don't teenagers use contraception? A qualitative interview study. EUR J CONTRACEP REPR 2010; 15:197-204. [DOI: 10.3109/13625181003763456] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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No change in adolescents' neglect on contraceptive use over two decades. Arch Gynecol Obstet 2010; 283:551-7. [PMID: 20162288 DOI: 10.1007/s00404-010-1392-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 02/02/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE The sexual activity and contraceptive use is evaluated over 21 years amongst Danish adolescents in ninth grade. METHODS A repeated, cross-sectional questionnaire study in the municipality of Viborg, comparing the results of four consecutive surveys between 1986 and 2007. RESULTS In 2007, 40% of the pupils had sexual debut at an average age of 15.3 ± 1.5 years. At sexual debut condoms were used in 77% of the adolescents and the contraceptive pill in 15%. At their latest coitus 34% used any contraceptive pill as 27% of pupils changed from use of condom to the pill. Practical experience with condoms was found in 90% of both sexes at sexual debut. Fourteen percent of the adolescents used no contraception at all at debut in 2007, which is similar to 1986, 1993, and 2000. Eighteen percent of the pupils used no contraception at all at their last intercourse in 2007 and 2000. CONCLUSION Knowledge about and use of condoms is substantial amongst adolescents already at sexual debut. A shift is confirmed from condoms at first coitus to more frequent use of the pill later on. A considerable number of pupils (10-20%) are neither protected against sexually transmitted infections nor pregnancy at first or later intercourse.
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Pérez G, Villegas R, Ruiz-Muñoz D, Rodríguez-Sanz M. Determinants of oral contraception use in a southern European setting. EUR J CONTRACEP REPR 2010; 15:48-53. [DOI: 10.3109/13625180903586306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Characteristics of sexual behavior in Spanish adolescents. THE SPANISH JOURNAL OF PSYCHOLOGY 2009; 12:471-84. [PMID: 19899649 DOI: 10.1017/s1138741600001852] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this study is to describe some characteristics of the sexual behavior of adolescents in Spain and to compare these characteristics according to gender, using a cross-sectional survey. Participants were 1.279 male and female adolescents who reported having had sexual intercourse. A questionnaire about sexual behavior was applied at their high schools and during school hours. Data were collected between 2006 and 2007. Mean age at the onset of sexual intercourse was 14.8 years in males and 15.0 years in females. Males and females were different according to the type of partner at the last sexual intercourse: 63.0% of males had a steady partner compared to 90.5% of females (p < 0.01). The mean number of sexual partners during the last 12 months was higher in males than in females (M = 2.1 and M = 1.5 partners, for males and females, respectively, p < 0.01). 50.0% of males had sexual intercourse under the effects of drugs versus 39.3% of females (p < 0.01). STD and HIV prevention programs should be designed considering the differences according to adolescents' sex.
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Casamitjana M, Sala M, Ochoa D, Fusté P, Castells X, Alameda F. Results of a cervical cancer screening programme from an area of Barcelona (Spain) with a large immigrant population. Eur J Public Health 2009; 19:499-503. [PMID: 19435798 DOI: 10.1093/eurpub/ckp029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To assess the participation rate and results of cytological assessment in the context of cervical cancer screening activities in an area of Barcelona (Spain) with a large immigrant population. METHODS Descriptive retrospective study of cytologies performed between 2001 and 2006 in women > or =14 years of age living in 2 out of 10 districts of Barcelona (n = 129 327) and participating in cervical cancer screening activities within a sexual and reproductive health care programme. RESULTS Between 2001 and 2006, overall participation among women aged 20- to 64-years old was 50.7%, with higher participation among women aged 20-34 years than among those aged 50-64 years (63.8 and 36.0%, respectively; P < 0.01). The median frequency was 0.5 cytologies/year. The rate of pathological results increased from 11.4 per thousand in 2001 to 29.0 per thousand in 2006 (P < 0.001). This increase was higher among younger women and was mainly due to an increase in the rate of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (L-SIL). CONCLUSIONS These results show a low rate of participation in the public cervical cancer screening programme and an increase in the number of pathological results during the study period. These results provide useful information at a time when significant changes in the prevention of cervical cancer are being planned.
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Affiliation(s)
- Montserrat Casamitjana
- Health Services Evaluation and Clinical Epidemiology Service, Hospital del Mar-IMIM, Passeig Marítim 25-029, Barcelona, Spain
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